The almond is closely related to the peach, apricot, and cherry (all classified as drupes). The most commonly used portion of the almond is the nut. A compound called amygdalin differentiates the bitter almond from the sweet almond. In the presence of water (hydrolysis), amygdalin yields glucose and the chemicals benzaldehyde and hydrocyanic acid (HCN). HCN, the salts of which are known as cyanide, is poisonous. To be used in food or as a flavoring agent, the HCN must be removed from the bitter almond oil. Once it is removed, the oil is called volatile almond oil and is considered to be almost pure benzaldehyde. Volatile almond oil can still be toxic in large amounts.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

GRADE *

"Laetrile" is an alternative cancer drug marketed in Mexico and other countries outside of the United States. Laetrile is derived from amygdalin, found in the pits of fruits and nuts such as the bitter almond. Early evidence suggests that laetrile is not beneficial in the treatment of cancer. In 1982, the U.S. National Cancer Institute concluded that laetrile was not effective for cancer therapy. Nonetheless, many people still travel to use this therapy outside the United States. Multiple cases of cyanide poisoning, including deaths, have been associated with laetrile therapy.

D

* Key to grades

A: Strong scientific evidence for this useB: Good scientific evidence for this useC: Unclear scientific evidence for this useD: Fair scientific evidence for this use (it may not work)F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Due to potential toxicity, there is no widely accepted standard dose for bitter almond.

Children (younger than 18 years)

Due to potential toxicity, bitter almond products should be avoided in children.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Allergies to almonds are common and have lead to severe reactions, including throat swelling that interferes with breathing. If allergic to other nuts, it is probably best to avoid almonds.

Side Effects and Warnings

Laetrile, derived from the amygdalin found in the pits of fruits and nuts such as the bitter almond, is considered unsafe in any form due to its potential for causing cyanide toxicity. Reactions are more severe when laetrile is taken by mouth than when injected into a vein or muscle. Some of the side effects have included dilated pupils, dizziness, drooping eyelids, drowsiness, headache, increased breathing, muscle weakness, nausea, stomach pain, and vomiting. High doses of bitter almond or laetrile may lead to a slowing of brain functions or breathing. Several cases of cyanide poisoning (some fatal) have been reported.

Drowsiness or sedation may occur with bitter almond. Use cautiously if driving or operating heavy machinery.

Pregnancy and Breastfeeding

Bitter almonds are not recommended in pregnant or breastfeeding women due to insufficient available data and potential risk for birth defects.

In theory, bitter almond may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery. Avoid the use of alcohol as almond oil was shown in mice to cause a toxic reaction (nausea, vomiting, increased breathing, sweating) when taken with alcohol.

Amygdalin, bitter almond, and laetrile may also interact with analgesics (pain-relievers), central nervous system (CNS) depressants, agents that suppress or stimulate the immune system, and agents that are excreted through the kidneys. However, human evidence is lacking.

Interactions with Herbs and Dietary Supplements

Bitter almond may increase the amount of drowsiness caused by some herbs or supplements. Caution is advised while driving or operating machinery.

Amygdalin, bitter almond, and laetrile may also interact with analgesics (pain-relievers), central nervous system (CNS) depressants, agents that suppress or stimulate the immune system, and agents that are excreted through the kidneys. However, human evidence is lacking.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.